Evaluation of a French Regional Telemedicine Network Dedicated to Neurological Emergencies: A 14-Year Study

Bustos, Elisabeth Medeiros de; Berthier, Eric; Chavot, D.; Bouamra, Benjamin; Moulin, Thierry

doi:10.1089/tmj.2017.0035

Cited by 23 publications

(9 citation statements)

References 25 publications

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“…Telemedicine ET was most accessible in the medical residency program, primarily in specialties where telemedicine activity was well developed in France. 12 Respondents in the survey stated emergency medicine, dermatology, geriatrics, neurology and radiology as specialties with telemedicine training in residency. These results were similar to studies published in recent years in the US, including the survey conducted at the Thomas Jefferson University, where 70% of respondents stated integrated telemedicine training in the emergency medicine hospital rotation was valuable to their curriculum, 13 and a national survey of dermatology residents conducted to assess the exposure to teledermatology training and practice indicating the need to expand teledermatology training programs.…”

Section: Discussionmentioning

confidence: 99%

National survey of telemedicine education and training in medical schools in France

Yaghobian¹,

Ohannessian²,

Mathieu-Fritz

et al. 2019

J Telemed Telecare

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Introduction Telemedicine is a remote medical practice using information communication technology (ICT), and has been increasing in France since 2009. With all new forms of medical practice, education and training (ET) is required for quality and safety. To date, implementation of telemedicine ET has not been assessed in France. The objective of this study was to describe the implementation of telemedicine ET and evaluate the knowledge, attitudes and practices (KAP) of deans and associate deans from all medical schools in France. Methods A cross-sectional non-mandatory, descriptive online survey with a self-administered questionnaire was performed from 15 November to 6 December, 2017. Respondents were accessed through the ‘ Conférence des doyens des Facultés de médecine’. Results There were 48 respondents with a 47.4% response rate among deans. Telemedicine ET was limited in France; 10.4% in 1st year medicine (PACES); 4% in the final 3 years of medical school (D.F.A.S.M.) and 18.8% in medical residency. Emergency medicine, dermatology, radiology, neurology and geriatrics were specialties with implemented telemedicine training during residency. Of all respondents, 90% expressed a need to increase telemedicine ET, among which 75% accepted external support. A highly positive attitude towards telemedicine practice was reflected by 60.4% of respondents, and 56.2% practiced telemedicine at least once. Discussion This study was the first to assess national telemedicine ET implementation in France. Telemedicine was integrated into initial medical education; however, telemedicine ET remains limited despite the positive attitudes of deans and associate deans. Further research would need to be conducted on telemedicine ET implementation and KAP of medical students and residents.

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Section: Discussionmentioning

confidence: 99%

National survey of telemedicine education and training in medical schools in France

Yaghobian¹,

Ohannessian²,

Mathieu-Fritz

et al. 2019

J Telemed Telecare

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“…The largest study was conducted in France over a 14-year period and reported data for a total of 23,710 patients. 17 The 10 remaining studies reported data for 13,514 patients. 18–27 The total cumulative number of patients who received neurosurgical telemedicine consultations captured by this review was 37,224 (Table 3).…”

Section: Resultsmentioning

confidence: 99%

A systematic review of telehealth for the delivery of emergent neurosurgical care

et al. 2021

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Introduction In 2017, the American Association of Neurological Surgeons and Congress of Neurological Surgeons published a statement in support of adopting telemedicine technologies in neurosurgery. The position statement detailed the principles for use and summarised the active efforts at the time to address barriers that limited expansion of use, such as reimbursement, liability, credentialing and patient confidentiality. The primary aim of this systematic literature review was to identify the available published literature on the application of telemedicine to neurosurgical patient care, with a specific focus on neurotrauma and emergent neurological conditions. Methods This Level II systematic review of the literature was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 guidelines. Following removal of duplicates, 359 studies were yielded from database query. Following application of inclusion and exclusion criteria, 78 articles were identified for full-text review. Results Full-text screening yielded a total of 11 studies for the final analysis. The study interventions took place in seven unique countries and included both developed and developing nations. Data captured spanned the years 1997 to 2019. The total cumulative number of patients who received neurosurgical telemedicine consultations captured by this review was 37,224. Discussion This review of the literature suggests that telemedicine in emergent settings offers safe, feasible, and cost-reducing methods of increasing access to high acuity neurosurgical care and may serve to limit unnecessary inter-facility transfers. As infrastructure and regulatory guidelines continue to evolve, neurosurgical patients, both domestic and abroad, will benefit from improved access to expertise afforded by telemedicine technologies.

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“…One interesting finding is the breadth of conditions for which teleED was consulted. Prior reports have described single network experiences [26,27] or condition-specific telehealth interventions [28][29][30]. While many networks have developed telehealth infrastructure for cardiac emergencies, trauma, and stroke, that infrastructure is often used for other clinical scenarios where expert consultation may be valued.…”

Section: Plos Onementioning

confidence: 99%

HRSA’s evidence-based tele-emergency network grant program: Multi-site prospective cohort analysis across six rural emergency department telemedicine networks

et al. 2021

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Background The Health Resources and Services Administration (HRSA), Federal Office of Rural Health Policy (FORHP) funded the Evidence-Based Tele-Emergency Network Grant Program (EB TNGP) to serve the dual purpose of providing telehealth services in rural emergency departments (teleED) and systematically collecting data to inform the telehealth evidence base. This provided a unique opportunity to examine trends across multiple teleED networks and examine heterogeneity in processes and outcomes. Method and findings Six health systems received funding from HRSA under the EB TNGP to implement teleED services and they did so to 65 hospitals (91% rural) in 11 states. Three of the grantees provided teleED services to a general patient population while the remaining three grantees provided teleED services to specialized patient populations (i.e., stroke, behavioral health, critically ill children). Over a 26-month period (November 1, 2015 –December 31, 2017), each grantee submitted patient-level data for all their teleED encounters on a uniform set of measures to the data coordinating center. The six grantees reported a total of 4,324 teleED visits and 99.86% were technically successful. The teleED patients were predominantly adult, White, not Latinx, and covered by Medicare or private insurance. Across grantees, 7% of teleED patients needed resuscitation services, 58% were rated as emergent, and 30% were rated as urgent. Across grantees, 44.2% of teleED patients were transferred to another inpatient facility, 26.0% had a routine discharge, and 24.5% were admitted to the local inpatient facility. For the three grantees who served a general patient population, the most frequent presenting complaints for which teleED was activated were chest pain (25.7%), injury or trauma (17.1%), stroke symptoms (9.9%), mental/behavioral health (9.8%), and cardiac arrest (9.5%). The teleED consultation began before the local clinician exam in 37.8% of patients for the grantees who served a general patient population, but in only 1.9% of patients for the grantees who provided specialized services. Conclusions Grantees used teleED services for a representative rural population with urgent or emergent symptoms largely resulting in transfer to a distant hospital or inpatient admission locally. TeleED was often available as the first point of contact before a local provider examination. This finding points to the important role of teleED in improving access for rural ED patients.

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Evaluation of a French Regional Telemedicine Network Dedicated to Neurological Emergencies: A 14-Year Study

Abstract: Telemedicine networks facilitate acute-phase neurological assessment and prevent unnecessary secondary interhospital transfers.

Cited by 23 publications

References 25 publications

National survey of telemedicine education and training in medical schools in France

National survey of telemedicine education and training in medical schools in France

A systematic review of telehealth for the delivery of emergent neurosurgical care

HRSA’s evidence-based tele-emergency network grant program: Multi-site prospective cohort analysis across six rural emergency department telemedicine networks

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